Eddie Iroh's Intervention

Few Nigerians would have missed the recent desperate drama of Fabrice Muamba. Fabrice is the 24 year-old Bolton Wanderers English Premier League footballer whose close encounter with death on the football pitch gripped the entire world for three weeks just two months ago. The young player, born in the Democratic Republic of Congo [DRC], came to the United Kingdom with his parents as a seven year-old refugee. For the few who may have missed the dramatic incident, here is a brief recap. On March 17, at exactly 6.17 pm, Fabrice suddenly suffered a cardiac seizure and collapsed on the football field of Tottenham Hotspurs in North London. For 78 minutes the young man’s heart stopped beating and the capacity stadium was stunned into silence. The sequence of events that led to Muamba’s miraculous recovery need to be also recalled.

First of all, out of the crowd of football fans and fanatics stepped Dr Robert Deamer, a Tottenham Hotspurs supporter who happens to be a specialist heart surgeon. In a scene straight out of a movie script, one could almost hear him say, “Let me through; I am a doctor!” In a flash, Dr Deamer and a team of first aid workers surrounded the stricken soccer star and began a frantic effort to revive him. As concern grew to anxiety and the beautiful game of football became a tragedy rather than entertainment, Muamba was quickly stretchered off; the match was suspended, and his lifeless body was put in an ambulance. It is important to note that the hospital was not just merely a short drive away from the football stadium; it was also a specialist heart hospital. And who worked there but Dr Robert Deamer!

As most of us know by now, Muamba was out of intensive care within 72 hours and was sitting up and chatting in less than a week.

By the third week, the man who should have been dead was on his feet and out of hospital, home among his loved ones. Muamba has since made an emotional appearance before the tens of thousands of football fans who united in one universe of race-less, colourless humanity to pray for him. It was a spectacle that showcased the best in the British people.

In all this near-tragedy one could see the unmistakable hand of God. Muamba and his family are devout Christians who have maintained a strong commitment to their faith even in an increasingly secular society like the UK. But beneath the visible supreme hand of God one could also see the fingerprints of mortal humans all over Fabrice Muamba and his triumph over what should have been a tragedy.

It was therefore natural for me, as it must have been for many others, to wonder: If Fabrice Muamba were a Nigerian, playing on a Nigerian football pitch when he was so suddenly struck down by a hitherto undiscovered heart condition, would he be alive today? Younger readers will of course instinctively recall the experience of Kanu Nwankwo, although the essential difference is that Kanu’s condition was noticed in the course of a routine medical examination by his new club Inter Milan in November 1996. But like Kanu Fabrice has been assured not just of a full recovery but that he would play football again. However, older codgers like me would go back in time to August 1989 when Sam Okwaraji collapsed in the main bowl of the National Stadium, Surulere, Lagos, and died right there and then from cardiac arrest. Apologists for our state of affairs would say, “Eh, but that was 23 years ago! Things have changed. We have many more teaching hospitals.” And the “cynic” would ask “But to what extent have things changed, in quantity or quality?”

Let us use Muamba as a catalyst for a closer look at the state of both football and health care in our nation.

First there would not have been a doctor in the house simply because football in Nigeria is no longer a spectator sport, in spite of all the froth and noise about Premier League and many white elephant stadia.

Our stadia are empty on match days because Nigerian football fans have since migrated to Manchester United, Chelsea, Arsenal and other top English clubs. Our homes are bedecked with banners from these clubs which are six thousand kilometers from Nigeria. We know all their players and wear their jerseys but cannot name a single player in the Nigerian Premier League. Ordinarily normal families are fiercely divided and others engage in internecine warfare over rival clubs whose venues most Nigerians would never see in their lifetime except on TV screens. Even our domestic league matches are not broadcast by Nigerian television stations. Yet six years ago there was a fierce duel to wrestle the broadcast rights for English Premier League matches from the South African Super Sports channel and hand them over on a silver salver to Hi-TV, a hurriedly contrived TV channel whose owners happened to be in a position to use their offices to force out the South Africans. Meanwhile today the same South Africans are the only television network that broadcasts Nigerian Premier League matches, in spite of the miserable attendance, which would suggest that they are probably providing the service at considerable financial loss. Ironically we seem surprised when the game suffers a decline that has seen Nigeria plummet in African and world football rankings.

But let us say, for the purpose of patriotic fairness, that Fabrice Muamba was playing to a full capacity Lekan Salami Stadium in Ibadan, a short drive from the University Teaching Hospital, the oldest such hospital in Nigeria. And let us allow that there was a heart specialist among the spectators and he springs into action in the manner Dr Robert Deamer.

Let us also charitably concede that our surgeon had an ambulance at his disposal, complete with life-support equipment. Where would the story end? I suspect that Muamba would have ended up in a mortuary within a matter of hours. First there would be no electric power; possibly no diesel for the standby generators to operate Dr Deamer’s myriad equipment that would dazzle even the best locally- trained Nigerian doctors. And even if all these basics were mysteriously available, the Nigerian heart surgeon would have nothing near the very sophisticated equipment that helped to swiftly bring Muamba back to life.

Our surgeon would also probably not have the most rudimentary medical supplies because our hospitals, including the ones supposed to train our doctors, are still no more than the mere dispensaries that they were described as by the late General Murtala Muhammed in 1975. Of course we could fly Muamba to India, Israel and, even more shamelessly, to South Africa whom we threaten with sanctions and assets seizure every time we have the smallest tiff with them. But to get there we would have to put Muamba on a ventilator and in an air ambulance, all of which we certainly cannot mobilize in the critical hours between life and death.

It will be quite tempting to use our healthcare situation as a metaphor for the rest of the Nigerian condition, health being one of the pivotal planks of the social contract between the citizen and his state. But let us not go that far. The state of our hospitals is challenging enough without us wandering into the realms of security, education, housing and the rest. The fact that a growing number of Nigerians go to India, South Africa and now Israel for medical treatment speaks its own very clear and unimpeachable volumes. Those of us who cannot afford to fly abroad are bedeviled by even the most preventable and treatable diseases and pestilence. Malaria, which we began to “roll back” six years ago amidst the fanfare and ceremony for which we are more famous than results, is, according to WHO, a greater killer now than HIV-Aids. To be sure the Obasanjo administration cobbled up a National Health Insurance Scheme which few understand and even fewer benefit from. Still many of our citizens die in Accident and Emergency wards while hospital authorities insist on payment before treatment. Yet as long ago as 1979 Chief Obafemi Awolowo had articulated a healthcare service similar to the National Health Service of Britain which is totally free at the point of need, something which is still quite viable today if we can plug waste, drive for efficiency, and eliminate the sort of corruption that forced out a Minister of Health three years ago.

As far as I can recall at least since the Second Republic, nearly all Federal Ministers of Health have been medical doctors, some of them professors of medicine. But here is the devil in the detail. In 2011 and 2012the allocation for health was 5.73% and 5.95% respectively of the Federal budget. However, on the average, between 70-76% of this went to personnel cost alone! Any wonder then that the giant of Africa cannot boast of a single world-class medical facility that will cost less than the millions of dollars we spend abroad on personal medical care. Or that we cannot carry out a DNA test anywhere in the entire Federal Republic; samples have to be flown to South Africa, just as a good number of diagnostic and clinical verifications are similarly sent to that country.

Well, you can then pardon me for wondering what our president was doing at the recent World Summit on Nuclear Weapons in Seoul, South Korea, when we have not figured out how to fix our refineries or supply gas to our power stations. Needless to say, I am writing this with power from a standby generator!